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      SARS-CoV-2 Aerosol Transmission Through Vertical Sanitary Drains in High-Rise Buildings — Shenzhen, Guangdong Province, China, March 2022

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          Abstract

          What is already known about this topic?

          Aerosol transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via sanitary pipelines in high-rise buildings is possible, however, there is a lack of experimental evidence.

          What is added by this report?

          The field simulation experiment confirmed the existence of a vertical aerosol transmission pathway from toilet flush-soil stack-floor drains without water seal. This report provided experimental evidence for vertical aerosol transmission of clustered outbreaks on 18 floors of a 33-story residential building.

          What are the implications for public health practice?

          The water seal on floor drains is a necessary barrier to prevent the risk of vertical aerosol transmission of infectious disease pathogens in buildings. It is necessary not only to have a U-shaped trap in the drainage pipe, but also to be filled with water regularly.

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          Most cited references8

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          Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building

          The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fecal material has raised the possibility of viral transmission via a fecal–oral route. This study investigated whether SARS-CoV-2 transmission via fecal aerosols in the drainage pipe system may have been the cause of COVID-19 infection in a cluster of 3 families living in a high-rise building in China.
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            The SARS epidemic in Hong Kong: what lessons have we learned?

            L. Hung (2003)
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              Aerosol transmission of SARS-CoV-2 due to the chimney effect in two high-rise housing drainage stacks

              Stack aerosols are generated within vertical building drainage stacks during the discharge of wastewater containing feces and exhaled mucus from toilets and washbasins. Fifteen stack aerosol-related outbreaks of coronavirus disease 2019 (COVID-19) in high-rise buildings have been observed in Hong Kong and Guangzhou. Currently, we investigated two such outbreaks of COVID-19 in Hong Kong, identified the probable role of chimney effect-induced airflow in a building drainage system in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We injected tracer gas (SF6) into the drainage stacks via the water closet of the index case and monitored tracer gas concentrations in the bathrooms and along the facades of infected and non-infected flats and in roof vents. The air temperature, humidity, and pressure in vertical stacks were also monitored. The measured tracer gas distribution agreed with the observed distribution of the infected cases. Phylogenetic analysis of the SARS-CoV-2 genome sequences demonstrated clonal spread from a point source in cases along the same vertical column. The stack air pressure and temperature distributions suggested that stack aerosols can spread to indoors through pipe leaks which provide direct evidence for the long-range aerosol transmission of SARS-CoV-2 through drainage pipes via the chimney effect.
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                Author and article information

                Contributors
                Journal
                China CDC Wkly
                CCDCW
                China CDC Weekly
                Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention (Beijing, China )
                2096-7071
                10 June 2022
                : 4
                : 23
                : 489-493
                Affiliations
                [1 ] Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
                [2 ] Shenzhen Center for Disease Control and Prevention, Shenzhen City, Guangdong Province, China
                [3 ] Division of Chemical Analysis, Biology and Medicine, Beijing Institute of Metrology, Beijing, China
                [4 ] Futian District Center for Disease Control and Prevention, Shenzhen City, Guangdong Province, China
                Author notes

                & Joint first authors

                Article
                ccdcw-4-23-489
                10.46234/ccdcw2022.108
                9257235
                b2a54371-d43c-4040-8b05-d05cc3163251
                Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2022

                This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

                History
                : 5 May 2022
                : 8 June 2022
                Funding
                Supported by the Key Program of National Natural Science Foundation of China (92043201)
                Categories
                Preplanned Studies

                sars-cov-2,aerosol transmission,toilet flush,floor drain

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